Medical Forms
Medical Authorization Form
Employers may use this form to authorize medical care for a work-related visit:
- Pre-Employment Physicals
- Post-Accident Drug Screens
- Work-Related Injuries
- Breath Alcohol Testing
- Vaccines and TB Testing
Medical Records Release
We give every patient access to their medical information so that you can make better healthcare decisions. Please print and complete the Medical Records Release form to allow Total Access Urgent Care to share a patient’s medical records. This form can be used to release lab results, physical forms, or a patient’s medical history to someone other than the patient.
Parental Authorization Medical Release
The Parental Authorization form may be used to authorize Total Access Urgent Care to provide medical treatment for patients under eighteen years of age, in the absence of a parent or legal guardian.
Missouri Sports Physical Universal Form
Please complete the pertinent section of this form prior to arrival at Total Access Urgent Care for a sports physical.